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General NPI Number Information
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NPI Number | 1629257449
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Entity Type | Organization
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Legal Business Name | C.D.I. SERVICES CORPORATION
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 10/29/2007
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Provider Practice Location Address
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Address Line | 8635 W 3RD ST STE 585-WEST
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-360-9195
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Fax | 310-360-9196
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Provider Business Mailing Address
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Address Line | 8635 W 3RD ST STE 585-WEST
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-360-9195
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Fax | 310-360-9196
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Authorized Official
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Title or Position | OWNER
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Name | MRS. OPHELIA I CARRILLO
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Credential |
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Telephone | 310-360-9195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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